Evaluating Mental Health Practices among Community Health Extension Workers in Northern Nigeria: An Outcome Measure of Integrating Mental Health into Primary Healthcare Services

Background: According to the 1991 mental health policy, the vast majority of Nigeria’s population should be able to have access to mental health services through primary healthcare within a short distance of their homes. However, for a variety of reasons, the primary healthcare clinics do not provide these services. Objective: The aim of this study was to assess the current mental health practices of community health extension workers in northern Nigeria. Methods: This study evaluated the mental health practices and characteristics of 130 community health extension workers in northern Nigeria. A cross-sectional study design was employed, with data collected using a consecutive sampling procedure and a self-administered questionnaire adapted from a previous study in Nigeria. Results: The results showed that over 67% of respondents reported inadequate mental health practices. Correlation analysis revealed weak positive associations between knowledge and practice, particularly in domains such as mental health diagnosis (r = 0.179, p = 0.042) and referral to mental health facilities (r = 0.248, p = 0.005). Conclusion: Despite over three decades of efforts to integrate mental health into primary healthcare settings in Nigeria, community health workers’ mental health practice has remained significantly poor, implying that there are virtually no mental health services available in northern Nigeria’s primary healthcare settings. This highlights the critical need to reconsider and actively advance the integration of mental health services within primary care systems.